Approximately 80,000 cases of invasive gynecologic cancer are diagnosed annually in the United States and two-thirds of these women will survive at last 5 years. This encouraging prognosis contrasts with the distress attending disrupted life patterns and/or permanent body changes following cancer treatment. One life area that undergoes certain disruption for gynecologic cancer patients is sexual functioning. Before preventive or rehabilitative efforts can be implemented for such patients, information is needed on the specific nature, timing, and etiology of sexual difficulties for gynecologic cancer patients. Toward these objectives, the present research plan offers a controlled prospective longitudinal analysis of women's sexual functioning following the diagnosis and treatment of gynecologic cancer. The first aim of the proposed research plan determines the nature of sexual functioning for early stage cervical and endometrial cancer patients. This will be examined in two ways: (a) assessment of the range and frequency of sexual behavior, level of sexual responsiveness, and presence of sexual dysfunction; and (b) comparison of sexual functioning in women with gynecologic cancer with (i) a matched group of healthy women in no gynecologic distress, and (ii) a matched group of women with benign gynecologic disease. Group (i) will be used to estimate the base rate of sexual functioning deficits which occur under normal health and life circumstances, and Group (ii) will be used to estimate the level of sexual functioning deficits following non-life-threatening disease and major gynecologic treatment. The second aim provides delineation of the time point(s) at which gynecologic cancer patients experience sexual distress during the first postoperative year. For this, a prospective longitudinal methodology will be used in which subjects from the gynecologic cancer and the two comparison groups will be administered the sexual functioning assessment prior to treatment and at 4, 8 and 12 months posttreatment. The third aim proposes and tests a model of the contribution of sexual, medical, and psychosocial factors to the etiology of sexual distress among gynecologic cancer patients. Together these three aims will provide basic data on the nature of sexual functioning, the timing of sexual difficulties in the first postoperative year, and the variables which may be predictive of posttreatment sexual functioning. With these data, treatment programs focused on prevention can be designed to improve the quality of life for survivors of gynecologic cancer.